Spit to keep fit with futuristic health test

Subhasini Chandran runs 10 km regularly, and though she's nearly 40, friends tell her she looks much younger. But when the Chennai-based writer heard that a simple, one-time, saliva-based test to predict her future health was coming to India, she couldn't resist her curiosity.

Chandran called up Hyderabad-based MapMyGenome, ordered a kit and spat into it. Within days, her genome was analyzed, with details of diseases she is likelier to get than most Indians.

Though Chandran has no immediate reasons to worry, a counselling session later, she was ready to re-examine her hyperactive lifestyle.

"It was a reality check," Chandran said.

Personal genomics – decoding the genetic makeup of individuals to help them identify diseases they may suffer from in the future – is new in India.

But less than a year after the industry's first tentative steps in this country, a few hundred Indians have already had their genome analyzed down to its building blocks.

In a nation where palmistry and fortune telling remain popular, the handful of companies offering genetic testing here are confident that their offer – a more scientific glimpse in to the future – will find many takers.

Curiosity is motivating some, like Chandran, to get tested. For others, the possibility of scientifically confirming their likelihood to get breast cancer, diabetes, psychological disorders or coronary diseases, giving them a chance to modify lifestyles, is a powerful catalyst.

But the tests, already popular in the West, aren't cheap, costing between Rs 10,000 and Rs. 25,000. And as they become more popular in India, genome tests could bring with them serious privacy concerns and even social challenges.

When Saleem Mohammad returned to Chennai after completing his PhD in biotechnology the US, he found no one offering personal genetic analysis, though some Indians were shipping in kits from American firms.

In July 2012, Mohammad started X-Code Life Sciences, possibly the first Indian firm to offer genome analysis.

Six months later in January, Anu Acharya, also a biotechnologist, started offering the service through her firm, MapMyGenome, calling her product Genomepatri. Over 200 Indians have already bought the kit and returned spit samples.

The structure of the person's DNA – the basic proteins that the body is built of -- is extracted from the saliva and is analyzed in laboratories.

Based on the genetic map drawn from this analysis, detailed reports are sent to customers, explaining the likelihood of them acquiring specific diseases, in comparison to the average Indian.

Finally, customers are called for counselling sessions with experts who help them understand what the report means, and how they could change their lifestyles to reduce the likelihood of diseases they need to watch out for.

Some overreact on getting their reports. A few, like Gurgaon-based Parul Mittal were initially too scared to even look at them.

"Thankfully I didn't have too much to worry about," she said.

"All we've done, based on our discussions with the counsellor, is reduce the three whites: salt, sugar and white rice."

Because genetic testing is so completely new in India, counselling is critical to help customers understand results, Acharya of MapMyGenome said.

"We aren't just trying to sell kits," she said.

"It's also about helping people understand their genetic reports."

Like any new science, genetic analysis also faces skepticism.

"I knew the diseases my parents and grandparents had," said Mittal, who took the test with her husband and two children.

"What else could the test tell me, I wondered?"

A lot, it turns out.

Reddy, the counsellor, has no history of breast cancer in her family.

"But when I took the test, I found that my genetic makeup shows I'm likelier to get breast cancer than the average person," Reddy said.

Genetic analysis is also likely to get more accurate as it becomes popular in India. A greater number of samples means scientists have more statistical likelihood to correctly compute the average chance an Indian has of acquiring a disease.

As the field develops in India, that database could also help researchers understand Indian genetic tendencies better.

The Harvard Medical School, through its Personal Genome Project, is trying to sequence and publicize the genomes of 100,000 individuals globally for researchers to use.

But sharing genomic data with a third party could involve serious confidentiality concerns.

Leaked genomic information can be used to infer ancestry or to pin a crime on someone.

It can also affect insurance claims, employment opportunities and could bring social stigma, Vinod Scaria and Sridhar Sivasubbu, scientists at the Council for Scientific and Industrial Research – India's largest chain of research labs – argue on their personal genomics website meragenome.com.

"Imagine what an insurance company would do to try and access this information, even illegally," asked Anurag Chourasia, a biotechnologist with the Indian Council for Agricultural Research (ICAR).

Hyderabad-based entrepreneur Srini Ventrapragada doesn't mind sharing genomic information with his insurance company as long as it isn't misused.

"In India, there are definitely privacy issues," he said.

"I would like to see some regulations."

The test costs are also prohibitive, limiting its reach.

In the US, firms typically charge about $1000 (Rs. 50,000) for the test. Costs are lower in India – MapMyGenome charges Rs. 25,000 and X-Code Rs. 10,000. But the tests remain too expensive for most Indian citizens, X-Code founder Mohammad conceded.

Despite the steep cost however, Chandran, the Chennai-based writer said she is convinced the one-time test is good return on investment, and gives those who take it a chance to correct lifestyle choices in time to avoid major diseases.